Seeing Is Believing: Ultrasound in Pediatric Procedural Performance

Abstract

Point-of-care ultrasound is currently widely used across the landscape of pediatric care. Ultrasound machines are now smaller, are easier to use, and have much improved image quality. They have become common in emergency departments, ICUs, inpatient wards, and outpatient clinics. Recent growth of supportive evidence makes a strong case for using point-of-care ultrasound for pediatric interventions such as vascular access (in particular, central-line placement), lumbar puncture, fluid drainage (paracentesis, thoracentesis, pericardiocentesis), suprapubic aspiration, and soft tissue incision and drainage. Our review of this evidence reveals that point-of-care ultrasound has become a powerful tool for improving procedural success and patient safety. Pediatric patients and clinicians performing procedures stand to benefit greatly from point-of-care ultrasound, because seeing is believing.

Recommendations for hemodynamic monitoring for critically ill children—expert consensus statement issued by the cardiovascular dynamics section of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC)

“…Hence, it can be used, as an adjunct to other parameters, in children with hemodynamic instability to gain additional information required for making accurate clinical decisions such as myocardial failure, pulmonary hypertension, or cardiac tamponade [10]. It can help in understanding the pathophysiology of shock in children, and it can help in selecting timely, targeted specific, and right intervention [10,41,42]. The committee strongly recommended the use of cardiac ultrasound for hemodynamic evaluation of infants and children with hemodynamic instability.…”

Ultrasound-guided peripheral vascular catheterization in pediatric patients: a narrative review

“…One of the advantages of ultrasound-guided vascular catheterization is that the distinction between arteries and veins and the patency of the vessels can be confirmed by Doppler mode imaging achieved using the following techniques: (1) lightly squeezing the blood vessels with a probe under the color Doppler mode, (2) viewing the direction of blood flow under the color Doppler mode, and (3) distinguishing between arteries and veins using the wave pattern of the pulse wave Doppler mode [20,21]. Furthermore, combining these techniques may increase accuracy.…”

Recommendations for hemodynamic Monitoring for Critically Ill Children – Expert Consensus Statement issued by the Cardiovascular Dynamics Section of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC)

“…Hence, it can be used, as an adjunct to other parameters, in children with hemodynamic instability to gain additional information required for making accurate clinical decisions such as myocardial failure, pulmonary hypertension or cardiac tamponade [10]. It can help in understanding the pathophysiology of shock in children, and it can help in selecting timely, targeted speci c and right intervention [10,41,42].…”